In Sri Lanka, FHIR (Fast Healthcare Interoperability Resources) is increasingly being used to exchange healthcare data. Active adoption of FHIR standards signifies the country's commitment to improving healthcare interoperability. Currently, FHIR version R4 is in use, with exploration into R6 for specific use cases. The expected trajectory over the coming years is a significant increase in the rate of FHIR adoption, indicating a strong move towards a more connected and efficient healthcare data exchange system.

Rules and Support

Sri Lanka has established regulations and guidelines to mandate the use of standards in electronic health data exchange, specifically advising on the use of FHIR. Key points include:

  • Health Data Exchange Rules: Regulations mandate the use of standards for data exchange, with FHIR being specifically advised.
  • FHIR Requirements: The regulation explicitly mentions FHIR.
  • Deadlines and Fines: No compliance deadline or fines imposed for non-compliance.
  • Funding: No government funds are currently available to stimulate FHIR adoption.
  • Regulations and Guidelines Links:

National Setup

Sri Lanka has a structured approach to developing and implementing health data standards, including FHIR:

  • Standards Organization: The Health Information Unit of the Ministry of Health, Sri Lanka, is responsible for standards development, although it's not an independent organization. Health Information Unit
  • Implementation Guides: A base/core FHIR implementation guide is available for limited use cases. FHIR Implementation Guide
  • Terminology Services: A national FHIR terminology server is under development, indicating progress towards standardized healthcare terminologies.

Active Use Cases

FHIR is applied in various healthcare settings in Sri Lanka, demonstrating its versatility and impact:

  • Local Implementations: Referrals/Continuity of care and Terminology standards are in practice.
  • International Standards Use: The International Patient Summary standard is being utilized.
  • Key Projects: The National Electronic Health Record Initiative is a prime example of FHIR application.

Who's Using FHIR

FHIR adoption spans across multiple stakeholders in the healthcare industry:

  • Active Organizations: Ministry of Health, EHR system vendors, and others involved in the National Electronic Health Record Initiative.
  • Reasons for Adoption: Improving health outcomes, enhancing care workflows, and fostering innovation are among the main reasons.
  • Usage: FHIR is being used for messaging, REST API integration, and shorthand, with scores expressing the extent of usage (Messaging: 5, REST API: 4, Shorthand: 4).

Success Stories and Challenges

  • Benefits: Improved access to information and improved care workflows are clear success indicators.
  • Real Examples: The National Electronic Health Record Initiative stands out as a successful FHIR use case.
  • Difficulties: A notable challenge is the lack of FHIR knowledge among stakeholders.
  • Future Plans: Plans include SMART on FHIR integration, highlighting the direction towards advanced interoperability.

Future Plans

Sri Lanka has made considerable progress in FHIR adoption and plans to continue this momentum with:

  • Progress So Far: Acknowledgement of substantial progress aligning with expectations.
  • Next Steps: Development of a national FHIR data model, new FHIR standards for specific use cases, and launching pilot projects.
  • Expected Changes: Anticipation of significant cost savings, enhanced care coordination, and a more robust digital health ecosystem through FHIR adoption.

Contributors

The survey response from Chaminda Weerabaddana, Specialist in Health Informatics at the Ministry of Health, Sri Lanka, has provided valuable insights into the current state and future of FHIR in Sri Lanka.

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.